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Takahashi, Y., Jonas, W., Ransjo-Arvidson, A.-B., Lidfors, L., Uvnäs Moberg, K. & Nissen, E. (2015). Weight loss and low age are associated with intensity of rooting behaviours in newborn infants. Acta Paediatrica, 104(10), 1018-1023
Open this publication in new window or tab >>Weight loss and low age are associated with intensity of rooting behaviours in newborn infants
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2015 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 10, p. 1018-1023Article in journal (Refereed) Published
Abstract [en]

Aim: Little is known about the developing breastfeeding behaviour of newborn infants. This study describes infants' prebreastfeeding behaviour during the second day of life and explores possible associations with infant characteristics. Methods: We studied 13 mothers and healthy full-term infants after normal births. At 2448 hours of life, the newborns were placed in skin-to-skin contact with their mothers for breastfeeding and were video-filmed. The order, frequency and duration of predefined infant prefeeding behaviours and suckling were coded and analysed using computer-based video software. Results: Prefeeding behaviours occurred in the following order: rooting, hand to mouth movements, licking of the nipple and hand to breast to mouth movements. The infants started to suckle at a median of one to two minutes. Rooting was the most common behaviour, observed in 12 infants. The duration of rooting movements during the last minute before breastfeeding was inversely related to neonatal age (p = 0.001) and positively related to neonatal weight loss (p = 0.02) after birth. Conclusion: Infants exhibited a distinct sequence of prefeeding behaviours during the second day of life, and our findings suggest that rooting movements were governed by mechanisms involved in the regulation of food intake and weight gain.

Place, publisher, year, edition, pages
John Wiley & Sons, 2015
Keywords
Breastfeeding behaviour, Infant age, Infant weight loss, Prefeeding behaviour, Rooting behaviour
National Category
Nutrition and Dietetics Pediatrics
Research subject
Woman, Child and Family (WomFam)
Identifiers
urn:nbn:se:his:diva-13584 (URN)10.1111/apa.13077 (DOI)000362512100020 ()26073678 (PubMedID)2-s2.0-84976542346 (Scopus ID)
Available from: 2017-05-23 Created: 2017-05-23 Last updated: 2019-02-19Bibliographically approved
Ekström, A., Kylberg, E. & Nissen, E. (2012). A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study. Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, 7(2), 85-92
Open this publication in new window or tab >>A process-oriented breastfeeding training program for healthcare professionals to promote breastfeeding: an intervention study
2012 (English)In: Breastfeeding medicine : the official journal of the Academy of Breastfeeding Medicine, ISSN 1556-8342, Vol. 7, no 2, p. 85-92Article in journal (Refereed) Published
Abstract [en]

Abstract Aim: The aim of the study was to evaluate the effects of process-oriented training in supportive breastfeeding counseling for midwives and postnatal nurses on the time lapse between the initial breastfeeding session, introduction of breastmilk substitutes and solids, and the duration of breastfeeding. Materials and Methods: Ten municipalities in Sweden were randomized to either the intervention or control groups. The intervention included a process-oriented training program for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) living in either an intervention or control municipality were asked to participate in a longitudinal study to evaluate the care given. Data collection for control group A (CGA) (n=162) started before the intervention was initiated. Data for control group B (CGB) (n=172) were collected simultaneously with the intervention group (IG) (n=206). The mothers responded to questionnaires at 3 days, 3 months, and 9 months postpartum. Results: As a result of the process-oriented training program for midwives and postnatal nurses, the IG mothers had a significantly longer duration of exclusive breastfeeding, even if the initial breastfeeding session did not occur within 2 hours after birth, than the corresponding group of CGA mothers (p=0.01). Fewer infants in the IG received breastmilk substitutes (in the first week of life) without medical reasons compared with the control groups (p=0.01). The IG infants were significantly older (3.8 months) when breastmilk substitutes were introduced (after discharge from the hospital) compared with the infants in the control groups (CGA, 2.3 months, p=0.01; CGB, 2.5 months, p=0.03). Conclusion: A process-oriented training program for midwives and postnatal nurses was associated with a reduced number of infants being given breastmilk substitutes during the 1st week without medical reasons and delayed the introduction of breastmilk substitutes after discharge from the hospital.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2012
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-5772 (URN)10.1089/bfm.2010.0084 (DOI)000302777000004 ()22168946 (PubMedID)2-s2.0-84859623172 (Scopus ID)
Available from: 2012-04-25 Created: 2012-04-25 Last updated: 2018-05-03Bibliographically approved
Lilja, G., Edhborg, M. & Nissen, E. (2012). Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum. Scandinavian Journal of Caring Sciences, 26(2), 245-253
Open this publication in new window or tab >>Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum
2012 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 26, no 2, p. 245-253Article in journal (Refereed) Published
Abstract [en]

Depressive mood in women at childbirth predicts their mood and relationship with infant and partner during the first year postpartum Background: Although many studies have reported negative impact of maternal depressive symptoms on family relations, few studies have explored whether or not early depressive symptoms influence interfamily relationships. The aim was to describe first-time mothers feelings for their infant and partner during the first postpartum year in relation to maternal depressive symptoms. Research questions were addressed about: What is the prevalence of maternal depressive symptoms 10 days postpartum? How does maternal depressive symptoms on day 10 relate to her mood and feelings for the infant and partner at days 3 and 10, and at 6 and 12 months postpartum? Methods: A longitudinal study with first-time mothers, normal pregnancies, giving birth to healthy babies participated in the study; altogether, n = 419. Depressive symptoms were measured by Edinburgh Postnatal Depression Scale (EPDS) at 3 and 10 days. Additional questionnaires assessing the womans mood and relationship with her infant and partner were filled out at days 3 and 10, and at 6 and 12 months postpartum. Results: Twenty-two per cent of the women scored high on EPDS on day 10 postpartum. In addition, low mood seemed to remain prevalent over the babys first year, as confirmed by the mood scale at 6 and 12 months postpartum. Women with depressive symptoms showed less closeness, warmth and confidence as measured by the infant and partner relationship scales over the first year. Mothers with a high EPDS score on day 3 scored less optimal on the relationship scale to the infant at days 3 and 10, but not 6 or 12 months postpartum. Conclusions: To screen women for depressive symptoms, 10 days postpartum seems to be predictive of maternal assessment of maternalinfant relationship throughout the first year and enables early intervention.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2012
Keywords
depressive mood, father, mother-infant inter-action, newborn, nursing, relationship
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-6189 (URN)10.1111/j.1471-6712.2011.00925.x (DOI)000304000000006 ()2-s2.0-84861001457 (Scopus ID)
Available from: 2012-08-08 Created: 2012-08-08 Last updated: 2018-05-03Bibliographically approved
Handlin, L., Jonas, W., Ransjö-Arvidson, A.-B., Petersson, M., Uvnäs-Moberg, K. & Nissen, E. (2012). Influence of Common Birth Interventions on Maternal Blood Pressure Patterns During Breastfeeding 2 Days After Birth. Breastfeeding Medicine, 7(2), 93-99
Open this publication in new window or tab >>Influence of Common Birth Interventions on Maternal Blood Pressure Patterns During Breastfeeding 2 Days After Birth
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2012 (English)In: Breastfeeding Medicine, ISSN 1556-8253, Vol. 7, no 2, p. 93-99Article in journal (Refereed) Published
Abstract [en]

Objective: This study investigated possible influences of medical interventions during labor on maternal blood pressure during a breastfeed 2 days postpartum.

Subjects and Methods: Sixty-six primiparae with normal deliveries were consecutively recruited. Blood pressure was measured at –5, 10, 30, and 60 minutes during a morning breastfeed 2 days postpartum. Five treatment groups were formed based on the medical interventions received during labor: Non-medicated mothers (Control group, n=21); mothers receiving epidural analgesia (EDA) with oxytocin (OT) stimulation (EDAOT group, n=14); mothers receiving EDA without OT stimulation (EDAnon-OT group, n=7); mothers receiving OT stimulation only (OT intravenously [iv] group, n=9); and mothers receiving 10 IU of OT intramuscularly (im) only (OT im group, n=15).

Results: Baseline diastolic, but not systolic, blood pressure differed between the groups as displayed by significantly lower diastolic blood pressure in the EDAnon-OT group compared with the Control group, the OT iv group, and the EDAOT group (p=0.045, p=0.041, and p=0.024, respectively). Both systolic and diastolic blood pressure fell significantly during the breastfeeding session in the Control group (p=0.001 and p=0.004, respectively), the OT im group (p=0.006 and p=0.001, respectively), and the EDAOT group (p=0.028 and p=0.002, respectively), and the fall in diastolic blood pressure tended to be significant in the OT iv group (p=0.050). The duration of skin-to-skin contact before breastfeeding correlated positively with the decrease in systolic blood pressure in the OT im group (Rs=0.540, p=0.046).

Conclusion: Administration of EDA during labor lowers baseline diastolic blood pressure and abolishes the fall in blood pressure in response to a breastfeed 2 days after birth.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2012
National Category
Natural Sciences
Research subject
Natural sciences
Identifiers
urn:nbn:se:his:diva-5933 (URN)10.1089/bfm.2010.0099 (DOI)000302777000005 ()22313391 (PubMedID)2-s2.0-84859569252 (Scopus ID)
Available from: 2012-06-05 Created: 2012-06-05 Last updated: 2018-05-03Bibliographically approved
Carlsson, I.-M., Ziegert, K., Sahlberg-Blom, E. & Nissen, E. (2012). Maintaining power: Women's experiences from labour onset before admittance to maternity ward. Midwifery, 28(1), 86-92
Open this publication in new window or tab >>Maintaining power: Women's experiences from labour onset before admittance to maternity ward
2012 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 28, no 1, p. 86-92Article in journal (Refereed) Published
Abstract [en]

Background: in Sweden pregnant women are encouraged to remain at home until the active phase of labour. Recommendation is based on evidence, that women who seek care and are admitted in the latent phase of labour are subjected to more obstetric interventions and suffer more complications than women who remain at home until the active phase of labour. The aim of this study was to obtain a deeper understanding of how women, who remain at home until the active phase of labour, experience the period from labour onset until admission to labour ward. Method: interviews were conducted with 19 women after they had given birth to their first child. A Constructivist Grounded theory method was used. Findings: 'Maintaining power' was identified as the core category, explaining the women's experience of having enough power, when the labour started. Four related categories: to share the experience with another', to listen to the rhythm of the body', to distract oneself and to be encased in a glass vessel', explained how the women coped and thereby maintained power. Conclusions: the first time mothers in this study, who managed to stay at home during the latent phase of labour, had a sense of power that was expressed as a driving force towards the birth, a bodily and mental strength and the right to decide over their own bodies. This implies that women who maintain power have the ability to make choices during the birth process. The professionals need to be sensitive, supportive and respectful to women's own preferences in the health-care encounter, to promote the existing power throughout the birthing process. (C) 2010 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2012
Keywords
Experiences, Grounded theory, Labour onset, Maintaining power
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-5454 (URN)10.1016/j.midw.2010.11.011 (DOI)000299324500013 ()2-s2.0-84855931014 (Scopus ID)
Available from: 2012-02-23 Created: 2012-02-22 Last updated: 2018-05-03Bibliographically approved
Hertfelt Wahn, E. & Nissen, E. (2012). Teenage Childbearing in Sweden – Depressive Symptoms among Teenage Mothers, Influencing Factors, Perception of Support and Self-Esteem – A Comparative Cross-Sectional Study. Journal of Nursing & Care, 1(6), [art no] 123
Open this publication in new window or tab >>Teenage Childbearing in Sweden – Depressive Symptoms among Teenage Mothers, Influencing Factors, Perception of Support and Self-Esteem – A Comparative Cross-Sectional Study
2012 (English)In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 1, no 6, p. [art no] 123-Article in journal (Refereed) Published
Place, publisher, year, edition, pages
OMICS Publishing Group, 2012
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-7080 (URN)10.4172/2167-1168.1000123 (DOI)
Available from: 2013-01-30 Created: 2013-01-30 Last updated: 2018-05-03Bibliographically approved
Olsson, A., Robertson, E., Falk, K. & Nissen, E. (2011). Assessing women's sexual life after childbirth: the role of the postnatal check. Midwifery, 27(2), 195-202
Open this publication in new window or tab >>Assessing women's sexual life after childbirth: the role of the postnatal check
2011 (English)In: Midwifery, ISSN 0266-6138, E-ISSN 1532-3099, Vol. 27, no 2, p. 195-202Article in journal (Refereed) Published
Abstract [en]

Objective: to describe midwives' reflections on counselling women at the postnatal check with special focus on sexual life after childbirth. Design: qualitative descriptive study with focus group discussions as the method of data collection. Setting: antenatal clinics in Stockholm greater catchments' area. Participants: during 2006 and 2007, a voluntary sample of midwives from 10 different antenatal clinics were invited. Analysis: content analysis was undertaken through identification of codes, categories and themes. Findings: Two themes emerged: balancing between personal perceptions of the woman's needs and the health system restrictions and strategies for counselling about sexual life after childbirth'. The midwives tried to create a picture for themselves of the woman coming for the postnatal check and her needs before the consulation. This picture guided the midwives, but lack of time and knowledge restricted them when counselling on sexual life after childbirth. Two different strategies in counselling were identified, one task-oriented and one subject-oriented. Demands and time restrictions led midwives to distance themselves from their clients. A task-oriented approach was more visible in midwives' encounters with foreign-born women, where linguistic difficulties, cultural diversity and narrow time frames restricted the midwives' effectiveness and/or sensitivity as caregivers. In contrast, the subject-oriented strategy meant 'getting in tune', i.e. listening to the woman when she expressed her feelings and emotions, encouraging the woman to be an active participant in decisions involving her care. This strategy is used for women who arouse midwives' empathy and when there is some form of recognition and understanding. Conclusion: The picture created of the woman and her needs guided the midwives, but lack of knowledge and time limitations restricted counselling on sexual life after childbirth. Two counselling strategies were identified, one task-oriented and one subject-oriented. Balancing these two counselling strategies improves both the ethical aspects and the quality of the counselling. (C) 2009 Elsevier Ltd. All rights reserved.

Place, publisher, year, edition, pages
Elsevier, 2011
Keywords
Postnatal visit, Sexual life, Midwifery care, Focus group
National Category
Nursing
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-5549 (URN)10.1016/j.midw.2009.04.003 (DOI)000289071200014 ()19570597 (PubMedID)2-s2.0-79953222666 (Scopus ID)
Available from: 2012-03-08 Created: 2012-03-01 Last updated: 2018-05-03Bibliographically approved
Widström, A.-M., Lilja, G., Aaltomaa-Michalias, P., Dahllöf, A., Lintula, M. & Nissen, E. (2011). Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation. Acta Paediatrica, 100(1), 79-85
Open this publication in new window or tab >>Newborn behaviour to locate the breast when skin-to-skin: a possible method for enabling early self-regulation
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2011 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 1, p. 79-85Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to provide a more detailed analysis of the infant’s behavioural sequence that begins immediately after birth and terminates with grasping the nipple, suckling and then falling asleep. Method:Twenty-eight full-term infants were videotaped immediately after birth. A video protocol was developed to examine infant behaviours identified from five random videotapes. Results:When birth crying had stopped, the babies showed a short period of relaxation and then successively became alert. They went through an ‘awakening phase’, an ‘active phase’ with movements of limbs, rooting activity and looking at the mother’s face, a ‘crawling phase’ with soliciting sounds, a ‘familiarization phase’ with licking of the areola, and a ‘suckling phase’ and last a ‘sleeping phase’. Five factors related to the time spent to locate the breast: more number of looks at the breast 10–20 min after birth (p < 0.0001); and exposure to meperidine (p = 0.0006) related to increased time. Early start of crawling (p = 0,0040); increased number of ‘soliciting sounds’ (p = 0.0022); and performing hand–breast–mouth movements (p = 0.0105) related to shorter time. Conclusion:  Inborn breastfeeding reflexes were depressed at birth, possibly because of a depressed sensory system. It is hypothesized that when the infant is given the option to peacefully go through the nine behavioural phases birth cry, relaxation, awakening, activity, crawling, resting, familiarization, suckling and sleeping when skin-to-skin with its mother this results in early optimalself-regulation.

Place, publisher, year, edition, pages
Foundation Acta Paediatrica, 2011
Keywords
Breastfeeding behaviour skin-to-skin, Newborn, Pain threshold, Psychological bonds, Self-regulation
National Category
Pediatrics
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-4662 (URN)10.1111/j.1651-2227.2010.01983.x (DOI)000285101100020 ()20712833 (PubMedID)2-s2.0-78650142389 (Scopus ID)
Available from: 2011-01-28 Created: 2011-01-28 Last updated: 2018-05-03Bibliographically approved
Ekström, A., Kylberg, E. & Nissen, E. (2010). A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding. In: Sigrid Agenäs, Gunilla Hallberg, Elisabeth Kylberg, Karin Perss on Waller & Bodil Ström Holst (Ed.), Proceedings of the Second Biannual Uppsala Symposium on lactation research in mammals and humans: The mammary gland in health and disease with particular focus on the mammary gland close post partum including indicators of inflammation and pathogens of the mammary gland. Paper presented at Second Biannual Uppsala Symposium on lactation research in mammals and humans: The mammary gland in health and disease, 7-8 December 2010, Ultuna, Uppsala (pp. 9). Uppsala: CRU
Open this publication in new window or tab >>A Process-Oriented Breastfeeding Training Program for Healthcare Professionals to Promote Breastfeeding
2010 (English)In: Proceedings of the Second Biannual Uppsala Symposium on lactation research in mammals and humans: The mammary gland in health and disease with particular focus on the mammary gland close post partum including indicators of inflammation and pathogens of the mammary gland / [ed] Sigrid Agenäs, Gunilla Hallberg, Elisabeth Kylberg, Karin Perss on Waller & Bodil Ström Holst, Uppsala: CRU , 2010, p. 9-Conference paper, Published paper (Refereed)
Abstract [en]

Introduction: The impact of giving an infant food other than breast milk depends on several factors. Evidence to date supports the recommendation for exclusive breastfeeding for six months.

The aim of the this study was to evaluate the effect of a process-oriented training in support during childbirth and breastfeeding for midwives and postnatal nurses in relation to  the time of initial breastfeeding session, introduction of breast milk substitute and solids effects on  the duration of breastfeeding.

Materials and methods: Ten municipalities in Sweden were randomized to either intervention (IG) or control groups (CGA and CGB). The intervention included a process-oriented training program* for midwives and postnatal nurses in the intervention municipalities. Primiparas (n=540) who were living at either site were asked to respond to questionnaires at three days, three and nine months postpartum. Data collection for mothers in CGA (n=162) started before effects of the intervention could be studied, CGB (n=172) was collected simultaneously with the IG (n=206).

Results: Preliminary results showed that fewer infants in the IG received breast milk substitute (the first week of life) without medical reasons (p=0.01) and were older (3.8 months) when breast milk substitute was introduced after discharge compared with the infants in the control groups (CGA 2.3 months p= 0.01 and CGB 2.5 months p= 0.03).

Discussion and Conclusion: A process-oriented training program for midwives and postnatal nurses (by changed attitudes among health staff and changing mothers self imaging) reduced the number of infants who got breastmilk substitute during the first week without medical reasons and delayed the introduction of breast milk substitute after the first week.

 

Place, publisher, year, edition, pages
Uppsala: CRU, 2010
Series
CRU Report, ISSN 1404-5915 ; 24
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-4760 (URN)978‐91‐576‐9013‐5 (ISBN)
Conference
Second Biannual Uppsala Symposium on lactation research in mammals and humans: The mammary gland in health and disease, 7-8 December 2010, Ultuna, Uppsala
Available from: 2011-03-07 Created: 2011-03-07 Last updated: 2018-05-03Bibliographically approved
Olsson, A., Robertson, E., Björklund, A. & Nissen, E. (2010). Fatherhood in focus, sexual activity can wait: New fathers' experience about sexual life after childbirth. Scandinavian Journal of Caring Sciences, 24(4), 716-725
Open this publication in new window or tab >>Fatherhood in focus, sexual activity can wait: New fathers' experience about sexual life after childbirth
2010 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 24, no 4, p. 716-725Article in journal (Refereed) Published
Abstract [en]

Background: Becoming a parent is overwhelming for most men  and  women  and  alters  the  sexual  relationship  for many couples. Aim: To describe fathers’ experience about sexual life after childbirth within the first 6 months after childbirth. Method: A descriptive design, using content analysis with a qualitative approach, based on focus group discussions and one-to-one interviews. Participants: Eight  first-time  and  two  subsequent  fathers participated. Results: Three subthemes were identified: Struggling between stereotypes  and  personal  perceptions  of  male  sexuality  during transition to fatherhood; new frames for negotiating sex; a need to feel  safe  and  at  ease  in  the  new  family  situation. The over-arching  theme  emerged  as  ‘transition  to  fatherhood  brings sexual life to a crossroads’ and guided us to a deeper understanding  of  the  difficulties  men  experience  during  the transition  to  fatherhood.  To  get  sexual  life  working,  a number  of  issues  had  to  be  resolved,  such  as  getting involved in the care of the baby and the household and getting  in  tune  with  their  partners  in  regard  to  sexual desire. The men needed to be reassured and prepared for this new situation by health care professionals. Conclusions: New fathers in our study put the baby in focus in early parenthood and were prepared to postpone sex until  both  parties  were  ready,  although  they  needed reassurance to feel at ease with the new family situation. The fathers’ perceptions of sexual life extended to include all kinds of closeness and touching, and it deviated from the stereotype of male sexuality. This is important information for health care providers and midwives to be aware of for their encounters with men (and women) during the transition  to  fatherhood,  and  parenthood  and  can  contribute  to  caring  science  with  a  gender  perspective  on adjustment of sexual life after childbirth.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2010
Keywords
sexuality, fatherhood, postnatal visit, childbirth
National Category
Medical and Health Sciences
Research subject
Medical sciences
Identifiers
urn:nbn:se:his:diva-4517 (URN)10.1111/j.1471-6712.2009.00768.x (DOI)000284121300012 ()20409069 (PubMedID)2-s2.0-78349241422 (Scopus ID)
Available from: 2010-12-30 Created: 2010-12-30 Last updated: 2019-11-13Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-0092-0822

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